| NPI | 1538701750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 11177) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 11177) |
| 103TC0700X Psychologist, Clinical (Licence: RI PS01801) | |
| 103TC0700X Psychologist, Clinical (Licence: ME PS2389) | |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2022-08-30 |